低频与高频超声诊断肝脏疾病的比较研究

Comparative study of low and high frequency ultrasound in diagnosis of liver diseases

目的:探讨高频超声诊断肝脏疾病的临床价值。方法:选择我院行肝脏超声检查的患者,先行低频超声检查,再行高频超声检查。高频超声或常规低频超声发现肝脏占位性病变且病灶距皮下≤70mm者120例(实性病灶83例,囊性病灶37例);早期肝硬化53例,轻度脂肪肝95例,共268例纳入研究。病灶长径>20mm的患者,中、重度脂肪肝,以及晚期肝硬化除外。对比分析高频超声和低频超声显示肝脏病灶的能力。结果:距皮下≤70mm的肝内实性病灶,高频超声发现83例,低频超声发现47例(χ2=45.97,P<0.001);最大径<5mm的实性占位性病灶,高频超声发现43例,低频超声发现或疑似9例(χ2=56.23,P<0.001)。距皮下≤70 mm的肝内囊性病灶,高频超声发现37例,低频超声发现25例(χ2=14.32,P<0.001),另外12例低频超声诊断为实性病变。早期肝硬化患者,高频超声发现硬化结节53例,低频超声发现或疑似硬化结节22例(χ2=43.81,P<0.001)。轻度脂肪肝患者,高频超声诊断95例,低频超声72例(χ2=26.17,P<0.001)。结论:高频超声可明显提高肝脏表浅部位微小病灶的检出率,可以早期诊断肝硬化、脂肪肝等弥漫性病变,是常规超声的有效补充。

Objective：To observe the clinical value of high frequency ultrasound in diagnosis of liver diseases. Methods： The selected 268 patients underwent high and low frequency ultrasound. 120 cases with liver lesions of subcutaneous ≤70 mm were detected with high frequency ultrasound or routine low frequency ultrasound （83 cases with solid lesions and 37 cases with cystic lesions） ,and 53 cases of early cirrhosis, 95 cases of mild fatty liver were enrolled also. The ability of high-frequency ultrasound and low-frequency ultrasound in the detection of liver lesions was compared. Results： In the solid hepatic lesions of subcutaneous 4 70 mm,83 cases were found by the high frequency ultrasound,47 cases by the low one （χ^2 =44.96,P〈0. 001）. In the focus with diameter 〈5 mm,43 cases were found by the high frequency ultrasound,9 cases were found or suspected by the low one （χ^2 =56.23,P〈0. 001）. In the cystic lesions from the subcutaneous χ^270 mm liver,37 cases were found by the high frequency ultrasound,25 cases by the low one （χ^2 = 14.32 ,P〈0. 001） ,another 12 cases were diagnosed as solid lesions with the low one. For patients with early liver cirrhosis,high frequency ultrasound found hardening nodules in 53 cases,the low one in 22 cases （χ^2 =43.81,P〈0. 001）. For patients with mild fatty liver,high frequency ultrasound diagnosed 95 cases,the low one diagnosed 72 cases （χ^2 = 26.17, P〈0. 001）. Conclusions： The high frequency ultrasound can significantly improve the detection rate of superficial minimal liver lesions,the early diagnosis of liver cirrhosis and fatty liver,and it is a useful complement to conventional ultrasound.